母亲血清乙型肝炎表面抗原、e抗原滴度与新生儿接种乙型肝炎疫苗免疫失败的关系

Relationship between maternal HBsAg, HBeAg titres and hepatitis B vaccine failure in infants born to HBV carrier mothers

目的 研究孕妇血清乙型肝炎表面抗原 (HBsAg)、乙型肝炎e抗原 (HBeAg)滴度与其新生儿接种乙型肝炎 (乙肝 )疫苗发生免疫失败的关系 ,探讨能否用孕妇血清HBsAg、HBeAg滴度代替血清HBVDNA浓度来衡量新生儿接种乙肝疫苗后发生免疫失败的危险性。方法 178例HB sAg、HBeAg双阳性母亲的新生儿接种乙肝疫苗后 ,随访至 2 4月龄 ,32例发生免疫失败 ,用斑点杂交法检测孕妇临产前血清乙型肝炎病毒 (HBV)DNA浓度、用酶联免疫吸附试验 (ELISA)法测定孕妇HBsAg和HBeAg滴度 ,研究孕妇HBsAg、HBeAg的滴度与其新生儿接种疫苗发生免疫失败的关系 ,并与孕妇血清HBVDNA浓度与其新生儿发生免疫失败的关系相比较。结果 随着母亲血清HB sAg、HBeAg滴度的升高 ,其新生儿发生免疫失败的危险性升高 ,当孕妇血清HBsAg滴度≥ 1∶10 0 0、HBeAg滴度≥ 1∶10 0时 ,分别有 2 6 .3%、31.4%的新生儿发生乙肝疫苗免疫失败 ,与当孕妇血清HBVDNA浓度≥ 12 5pg/ml,新生儿发生免疫失败的危险性相当。 结论 孕妇血清HBsAg、HBeAg高滴度与其新生儿接种疫苗发生免疫失败有密切联系 ,孕妇血清HBsAg滴度≥ 1∶10 0 0、HBeAg滴度≥ 1∶10 0能够代替血清HBVDNA浓度≥ 12 5 pg/ml作为衡量孕妇的乙肝高传染性的指标来预测新生儿发生免疫失败的危险?

Objective To investigate the relationship between maternal HBsAg, HBeAg titers and hepatitis B vaccine failure in infants born to HBV carrier mothers. To explore the possibilities of predicting vaccine failure using maternal HBsAg, HBeAg titers. Methods 178 infants born to HBsAg, HBeAg sero positive mothers were immunized with hepatitis B vaccine at birth, 1,6 month respectively and have been followed up for 24 months. 32 of those infants became chronic carriers which were defined as vaccine failure. The sera of all mothers at delivery or before delivery were tested for HBsAg, HBeAg titers using ELISA and HBV DNA using dot hybridization method to investigate its relationship with vaccine failure. Results As maternal HBsAg, HBeAg titers elevated, her infant's risk of vaccine failure also increased. When maternal HBV DNA was 125 pg/ml or greater, HBsAg titer is 1∶1 000 and HBeAg titer is 1∶100 or greater, the vaccine failure incidence were 33.7%, 26.3% and 31.4% respectively.Conclusions The result showed that maternal HBsAg, HBeAg titer were well related to the risk of infant vaccine failure. HBV DNA load(≥125 pg/ml), HBeAg(≥1∶100) and HBsAg(≥1∶1 000) titers were good predictors for measuring risk of vaccine failure.